“Universal Precautions”: Perinatal Touch and Examination after Childhood Sexual Abuse


  • Jan Coles PhD, MBBS, MMed, DipChildHealth,

    Corresponding author
    1. Jan Coles is a Senior Research Fellow/Senior Lecturer at the Child Abuse Prevention Research Australia/Department of General Practice
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  • Kay Jones PhD, MTD, BSW

    1. Kay Jones is a Senior Research Fellow in the Department of General Practice, Monash University, Notting Hill, Victoria, Australia
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  • Phase two of the research was supported by the Vera Scantlebury Brown Child Welfare Memorial Trust Scholarship awarded to Dr. Jan Coles by the Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia, on behalf of the Vera Scantlebury Brown Memorial Trust, Melbourne, Victoria, Australia.

Dr. Jan Coles, Senior Research Fellow, Child Abuse Prevention Research Australia, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia.


Background: Childhood sexual abuse is a common experience of Australian women with 1 woman in 3 reporting unwanted sexual activity, and 1 in 10 reporting attempted or penetrative sexual abuse before 16 years of age. The objective of this study was to explore women's responses to perinatal professional touch and examination of themselves and their babies. Methods: Eighteen women were interviewed using an in-depth semistructured qualitative method. Interviews were recorded and transcribed. The interviews were coded and thematically analyzed, using NVivo to assist with data management. To ensure rigor, four initial interviews were coded by a second researcher and discrepancies resolved. Results: Two key themes were identified by childhood sexual abuse survivors as important in improving service provision: safety issues for survivors and their babies in the clinical encounter and ways of making service provision safer. Conclusions: Childhood sexual abuse survivors experienced pain, dissociation, fear, blame, helplessness, and guilt in their encounters with health care practitioners. These experiences led to the development of a set of “Universal Precautions” for perinatal professionals responding to women and their children.